低出生体重児を出産した母親とドメスティック・バイオレンス(DV)との関連 <原著>

目的: 本研究では, 低出生体重児を出産した母親とドメスティック・バイオレンス(DV)との関連について検証することを目的とした.

対象と方法: 2006年7月から10月に, 乳児4ヶ月健診に訪れた母親1,686人に研究協力依頼を行った. 自己記入式質問紙を用い, 対象者の背景, 妊娠前, 妊娠中における10項目の暴力行為の被害経験の有無とその程度について尋ねた. 分析は, 低出生体重児を出産した母親を低出生体重児群, 低出生体重でない児を出産した母親を非低出生体重児群とし, χ2検定および, 多重ロジスティク回帰分析等を用いて調整オッズ比(以下aORとする)を算出した.

結果: 質問紙の回収は1,385人(82.1%), 分析した対象者は1,186人(70.3%)であり, そのうち低出生体重児は88人(7.4%)であった. 暴力を受けた経験のある対象者の割合は, 児の出生体重が少ない母親程, 高い傾向がみられた. 2群間における暴力行為の被害経験との関連では, 非低出生体重児群に比べ, 低出生体重児群は, 妊娠前「交友関係や電話を細かく監視される」経験割合が有意に高く(p=0.033), aORは2.23倍(95%CI: 1.01-4.87)であった. 妊娠中に「性的行為を強要される」経験割合(p=0.Ol6), 「交友関係や電話を細かく監視される」経験割合(p=0.034)も低出生体重児の方が有意に高く, 各々aOR2.84(95%CI: 1.07-7.53), aOR2.58(95%CI: 1.06-6.28)であった.

結論: 2500g以上の児を出産した母親に比べ, 低出生体重児を出産した母親は, 妊娠前に「交友関係や電話を細かく監視された」母親が2.2倍, 妊娠中では26倍, 妊娠中に「性的行為を強要された」者は2.8倍と高くみられ, 低出生体重児出産の原因になりうることが示唆された. 助産師等の医療従事者は, 低出生体重児を出産した母親の背景にDVがあるかもしれないという視点で観察し, DVの早期発見・予防に努める必要がある.

Objectives: This study sought to determine the relationship between postpartum mothers who experienced Domestic Violence before or during pregnancy, with the birth of low weight birth babies.

Methods: Self report questionnaires on domestic violence were distributed to 1,686 women who attended routine medical examinations organized by Local Dept. of Health and Welfare between July 2006 and October 2006. The women were asked about their backgrounds and frequency, if any, of domestic violence in the questionnaires. Responses were divided into two groups: women who gave birth to low weight birth babies and those who gave birth to normal weight babies. Chi-tests and multiple logistic regression analysis were used to review the relationship between mothers who gave birth to low weight birth babies and domestic violence.

Results: There were 1,385 responses (return rate=82.1%), 1,186 (70.3%) were analyzed. 88 (7.4%) of mothers gave birth to low weight birth babies. 200 mothers (16.9%) experienced physical or nonphysical abuse by their intimate partner during or before pregnancy. The lower the weight of the low weight birth babies, the higher the ratio of violence experienced by the mother. Significantly large number of mothers with low weight birth babies experienced the following; had friends and acquaintances and also their personal telephone history scrutinized by partners; before pregnancy, (p=0.033) (aOR=2.23, 95%CI: 1.01-4.87), during pregnancy, (p=0.034) (aOR=2.58, 95%CI:1.06-6.28), and/or had experienced sexual abuse during pregnancy, (p=0.016) (aOR=2.84, 95%CI: 1.07-7.53).

Conclusion: These results suggest that experiences such as "had friends, acquaintances and telephone history scrutinized by partners before pregnancy (aOR=2.2) and during pregnancy (aOR-2.6)" and "forced sexual intercourse during the pregnancy" (aOR=2.8), were identified as having an effect on the event of mothers giving birth to low weight birth babies. It is suggested that medical workers such as midwives, who have more opportunity to meet mothers who delivered low weight birth babies, observe the mothers. These observations may reveal situations involving DV, and possibly prevent the continuation of the situation.